Clinical efficacy analysis of tip‑flexible suctioning ureteral access sheath combined with disposable flexible ureteroscope to treat 2-4 cm renal stones

Abstract

Purpose This study aims to compare the clinical efficacy of tip-flexible suctioning ureteral access (TFS-UAS) combined with disposable flexible ureteroscope (DFU) to treat large renal calculi (2 ~ 4 cm) with the use of traditional ureteral access sheath (T-UAS). Methods A retrospective study was conducted to collect clinical data from 238 patients who underwent retrograde intrarenal surgery (RIRS) at Ganzhou People’s Hospital between January 2019 and October 2023. The observation group consisted of 125 patients who utilized TFS-UAS, while the control group consisted of 113 patients who utilized UAS. Comparisons were made between the two groups regarding stone-free rate (SFR), complication rates, operation time, and average hospital stay. Results All surgeries involving the 238 patients were successfully completed. The stone-free rates for the observation group at the first and 30th day post-surgery were 87.20% and 73.45% respectively, whereas for the control group, the rates were 95.20% and 85.84%, demonstrating a statistically significant difference (P < 0.05). The overall complication rates for the two groups were 1.6% and 14.16% respectively, with statistical significance (P < 0.001). The stone fragmentation and clearance operation times for the two groups were (101.17 ± 25.64) minutes and (86.23 ± 20.35) minutes respectively, indicating a statistically significant difference (P < 0.05). Conclusion In comparison to TUAS, the combination of TFS-UAS and DFU for treating renal calculi with a diameter of 2–4 cm may necessitate a longer duration for stone fragmentation and clearance. However, it exhibits a higher stone-free rate and a superior safety profile.